I’ve had this blog post tumbling through my head most of the week, and so it needs to be written so my brain can start processing other things…like different blog posts.
So, I don’t know if you know this, but we’re really lucky to have some of the things we do in the Twin Cities. Within the next week or so, almost all of the the hospitals in the area will have nitrous oxide as an option (Although it looks like the wait will be a number of months for St. John’s and Woodwinds), and I’m pretty certain that all of the birth centers have it available. Do you know how rare that is in the US? I know it’s popped up a couple of other places, but not in the widespread availability we have here. Ever since it first showed up as an option, I’ve been including it in our discussions of pain medication and interventions in classes, discussing the pros and cons. It is a medication, after all. But…..
Philosophically to ME anyway, using nitrous just doesn’t seem to be on the same plane as narcotics or epidurals. It doesn’t have any meaningful long term effects on mom or baby within a minute or two of not using the nitrous. It doesn’t involve restrictions on labor beyond the mom having to be the only one touching the mask and she must administer it herself. And the analgesic effects are only felt with active use, meaning a mom must actively breathe it in. The risks are low, the benefits are high, a mom can use it off and on throughout her labor as needed. It doesn’t work for everyone, though, and not everyone likes it.
You know what it reminds me of? Hydrotherapy, i.e. soaking in a tub or using a shower. The ease of use is about the same, the risks are low for both, you’ll still find providers actively against the practice. (ha!)
What worries me is that, as more people use nitrous for their labors and births, that this option– which was first embraced locally by birth center midwives– becomes another thing for “natural birth” proponents to place into the “bad” category. First of all, I’m not sure on any given day what people are labeling as “natural” (vaginal?), but the process of making decisions for birth isn’t a binary one. Things aren’t either good or bad. Pitocin isn’t inherently bad. Epidurals aren’t inherently bad. You can’t make decisions about birth that way. Birth and the process of making decisions IS a continuum. It’s always best to start from the place of the normal biological process of birth and then build in an understanding of where interventions, including pain management options, fall on that line. However, I’m concerned that parents aren’t choosing to take birth classes that help them understand the full scope and use, opting instead to take classes with little to no actual content, but endorsed by the hospital, or to take a class that does lean heavily on labeling certain interventions “bad”.
Using nitrous oxide is on one end of the pain management spectrum. Epidurals are on the other end. Both totally have their place in this world. As nitrous becomes an option everywhere and more families are informed about their pain management options, I’ll be interested to see how it ends up being labeled in the good/bad universe of birth options. For now, I’m going to very loudly and very firmly hold it as an option that may work for some people, that is fast acting, and has very few side effects when used properly…just like hydrotherapy.
That’s what I have for today. Thanks for listening.